Want to figure out what this addiction thing is all about? To start, a major challenge for traumatized people is to figure out how to manage strong emotions. Trying to dampen ‘negative’ emotions like anger, shame, sadness, despair, anxiety, or trying to feel positive things and get some sleep often top the list. Everyone knows that taking substances into our bodies work; some better than others and some more predictably than others. But food, sex, booze, drugs, gambling or whatever, used compulsively, often stop working or create other major problems. So, how to figure this out and not feel like some kind of degenerate? The unfortunate leftover from mind-body dualism and its explanation of mental issues, including addiction, was the belief that it was a biologically-based illness. The good news is that attention to issues like emotional regulation, attachment, and trauma histories has given us a more realistic understanding of addiction. Namely, that it usually operates to help people manage troubling emotions linked with trauma memories. Having worked with people with addiction problems for nearly 30 years, I can say that almost without exception that unresolved trauma was the engine that drove their addiction. Addiction and trauma are intimately linked, especially in cases of PTSD.
Strong emotions can short-circuit our thinking brain almost every time – they happen in an instant and before our thinking brain knows what is happening. That is part of the reason why much of our training is meant to teach us to react instinctively and ignore any emotional stuff. But, guess what – those things still get filed away to be dealt with later – our emotional brains remember. When people get home and come out of adrenaline mode and think it’s time to relax, this stuff can come back like a tsunami and it freaks people out. Emotions are too strong and happen unpredictably. The old way of trying to help traumatized people was to teach them to think their way through but this has finally been replaced by a focus on attachment and emotional dysregulation. Fancy words, but put simply, what we learned growing up about managing strong emotions has a direct impact on how we respond to them as adults. If we learned that parents and other caregivers were not available or could not be trusted to help us or listen to us when we were hurt or afraid, as an adult overwhelmed by what we did or saw overseas, then we are more likely to stuff it away and tough it through – just like we always had to do before.
Problem this time, is that it keeps coming back to bite you – getting triggered emotionally by all kinds of stuff and feeling like you are losing your mind. Your training and the old ways to manage do not work no matter how hard you try but the idea of lowering your guard and truly trusting somebody is foreign – even the thought of it can panic people. How to figure out how to talk about your stuff, including the secrets – the stuff that no one else on the planet knows about you? This is not blaming people for their deployment reactions; it does mean that if you are going to trust helpers, the stuff that is getting in the way from the past also has to be addressed. By talking with another person about what you went through growing up and what you learned from it can truly open the door to freedom from the past and help you find hope today and looking forward. The past does not have to govern the present and future but it does require courage and a willingness to give people a second chance.
It’s cold and dark, mid-March and barely 6 am as we hit the streets to start shift. I am the consulting head shrink on for a ridelong in the ambulance. The crew is upfront, I am strapped into the jumpseat as we chat and head to our assigned station... a parking lot behind a mall. We sat in the dark and wait, monitoring the chatter. Back across the harbour bridge to our next spot and wait again, not long this time …. The radio squawks and calls our number “320, proceed to vehicle reported stopped in 4-way intersection with driver unresponsive.” My adrenaline surges, heart pounding as I watch them shift into gear… “Proceeding Code 3”… lights and sirens. They are already getting ready for a suspected MI …. Their day has started. Looping around tiny dead-end streets we finally whip up to the scene. I could stay inside or get out. I decided the latter, one of them hands me a jacket with ‘Supervisor’ stenciled brightly across the back. Now that was irony if there ever was…. I did not even know my way round the bus. I would monitor and keep the gawkers back as they removed the unresponsive 80 year-old fellow from his car seat and followed their protocols to revive him, jolting him several times.... 5…. 6… 10 minutes, nothing. Compressions are still going but no words are spoken as we pack him up inside and off to Emerg to be officially pronounced. Family is already there, the devastation on their faces. I was with the Paramedics, and like them I was somehow also separated from feeling the pain of death for someone loved. You see their faces and tears but are somehow immune to it, you notice but don’t look at them directly; we were still occupied with the technical aspects of the call. Once he is in Emerg with the ERP, everyone knows this is a bad ending… off we go for a next call. Short stop at base for batteries for one of the 2-ways and on the road again. Almost immediately, next call, 911 from a 10-year old … her mother has fallen in the shower and does not answer to her. Off at high speed again, weaving through the morning rush, we arrive to find a woman in her late 40s in the most contorted shape I have ever seen. Her neck is crooked back like a crane staring blankly towards the sky. Amazed, I watch as the lead Paramedic does his thing, gently grasping her head and moving it slightly forward… She has vitals... We are on… Backboard! I help by clearing a path from the bathroom and bedroom ... everything is pushed roughly and quickly out of the way. They are busy as I catch the big eyes of the bewildered young girl looking up the stairs squarely at me. I still have the Supervisor’s jacket on… I have a responsibility. Down the stairs, I sit on the third step and tell her calmly that her mom’s back may be really hurt so we are going to take her down the stairs and into the ambulance and we will take her to the hospital. I watch as the big eyes relax slightly as her mother is carried down the stairs and maneuvered to the ambulance. The Paramedics are busy and don’t need to know that I switched back into therapist mode … It allowed me to feel useful. They are busy enough, they don’t need to know, I figure. I ask the little girl if she can call someone to come over or if there is somewhere she can go to be with people. She points to her neighbour’s house and heads out the door with me and disappears into the house. Barely 10 am and back on the road to Emerg, the guys tell me this is a slow morning …
How do you know when things may be going off the rails when this is the norm?
We are all working to do the right things to help individual soldiers look after their mental health. From command level, the medical and health promotion systems, and the grass-roots networks across the country - each one is doing their part to make it OK for people to come forward for help. However, we have all been told from day one that there are no individuals in the military, so, I think we have a problem! By focusing mental health as a private, individual responsibility and not looking at unit mental health, we end up making members into individuals once again. As we know, individuals exist outside the collective and there is no place for them. My question is, why wait until individual soldiers can’t bear it any longer? Sure, some of them are angry or let-down over things that happen on deployments, some feel ashamed or guilty, and some are simply mesmerized trying to make sense out of their experiences. But everyone is affected – either positively or negatively and most people have questions. The biggest ones – do I still belong, who are we now, where do we go from here?
Fear of standing out, cynicism, and shame are powerful forces that keep soldiers alone with their questions. In my experience, the things left unpacked at a unit level undermines cohesion and can develop into mental health problems for some members over time – each soldier fears that he or she is alone. The great news is that we already have a built-in system for soldiers and veterans to unload their stuff with each other – we exist in groups. But, I don’t mean bringing people together to single out ‘the messed up ones’ – this approach would undermine reconnection and could push some people further underground. But, what if sections or units had the chance to regroup in safe, honest, and well-run groups as a normal part of coming back home – not just because of a critical incident? Again, this would not be aimed at identifying those with ‘the problems’ – we all have problems, so this misses the point entirely. In my view, safe places to let down one’s guard with people who understand are entirely possible. Routinely unpacking and regrouping in the brotherhood is a much healthier way to go.
“Where is it that we were together? Who were you that I lived with? The brother. The friend. Darkness, light. Strife and love.” [From the Thin Red Line].
Powerful words that speak to intimate bonds between soldiers provided through shared struggle. But, these words also alert us to the profound emptiness that many feel but cannot put into words when they return home from deployments. Soldiers often tell me that they miss it, that they did not want it to end. This can easily be confused as a lust for war but what these men and women are referring to is the loss of intimate, yet unspoken, connection and love for other people without ever having to risk being mushy or sentimental. And, sometimes soldiers even wonder whether something is wrong with them to miss the terrible things of war. It can be incredibly empty for men and women to return to normal life that does not provide this level of unity with other people. They come home and feel let down, alone – isolated from other people, including their families and even from their military brothers and sisters.
The accepted ‘masculinity’ we learn in the military does not provide other ways to truly connect - loneliness and the pain of separation are kept to oneself. Words like intimacy or love for one’s brothers and sisters become so easily confused with sexuality that they cannot be said out loud. To be emotional, caring, or compassionate are realities of the human experience and without them life can be empty. To fill this void, many people I know – the warriors - do the adrenaline chase until they eventually crash. To be a strong man or woman is not clear cut - we are social creatures and we seek connection with other people - we do feel things like loneliness, tenderness, and vulnerability. Taking care of one’s ‘mental health’ may require military men and women to risk stepping outside the expected norm and to put these things into words and actions with somebody.
John J. Whelan
John J. Whelan, Ph.D., is the author of Going Crazy in the Green Machine, available now on FriesenPress.